Blue Nest's Costa Rica Wellness Retreat Registration Form

Blue Nest's Costa Rica Wellness Retreat

Please complete this form for the Blue Nest's Wellness Retreat in Costa Rica March 29-April 3rd 2027. Once completed, an email will be sent from Square with a link to pay. Once payment is received, your retreat and room choice are confirmed and you are all set! I look forward to retreating with you in Costa Rica!!
Your Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What city and state do you live in?
Which room are you requesting? Look on Blue Nest's Website for options
What is your second choice for your room for this retreat?
Do you want a private room or will you be sharing a room?
Do you want 1 King bed or 2 twin beds in your room?
If you have a roommate, please share your roommates name and email

First NameLast Name
Roommates email
example@example.com
Is your roommate over 18 years old?
Do you prefer to pay in full or pay monthly?
There are 3 full day excursions options. Which option would you most like to do?
Do you have any dietary requests such as gluten-free, vegetarian, etc?
Emergency Contact (Name)
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Liability Waiver & Cancellation Policy

By participating in this retreat, I acknowledge that I have read and agree to the following documents:

Liability Waiver
Cancellation & Refund Policy

These documents explain the risks associated with yoga, travel, retreat activities, and payment terms.

I understand that I am responsible for reading them in full before submitting this form.
Agreement Confirmation
We are so excited to have you join us on this incredible retreat in Costa Rica!!
Signature
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